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Pallotta L, Cammisotto V, Castellani V, Gioia A, Spigaroli M, Carlomagno D, Bartimoccia S, Nocella C, Cappelletti M, Pontone S, Carnevale R, Violi F, Vona R, Giordano C, Pignatelli P, Severi C. Diverticular Disease Worsening Is Associated with Increased Oxidative Stress and Gut Permeability: New Insights by Circulating Biomarkers. Antioxidants (Basel) 2023; 12:1537. [PMID: 37627532 PMCID: PMC10451802 DOI: 10.3390/antiox12081537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 07/26/2023] [Accepted: 07/28/2023] [Indexed: 08/27/2023] Open
Abstract
Diverticular disease (DD) management is impaired by its pathogenesis, which is still not completely defined, with an unmet clinical need for improved therapies. Ex vivo DD human models demonstrated the presence of a transmural oxidative imbalance that supports an ischemic pathogenesis. This study aimed to assess, with the use of circulating biomarkers, insights into DD pathogenesis and possible therapeutic targets. Nox2-derived peptide, H2O2, antioxidant capacity, isoprostanes, thromboxanes, TNF-α, LPS and zonulin were evaluated by ELISA in healthy subjects (HS) and asymptomatic and symptomatic DD patients. Compared to HS, DD patients presented low antioxidant capacity and increase in sNox2-dp, H2O2 and isoprostanes paralleled to a TNFα increase, lower than that of oxidative markers. TxB2 production correlated to Nox2 and isoprostanes, suggesting platelet activation. An increase in zonulin and LPS highlighted the role of gut permeability and LPS translocation in DD pathogenesis. The increase of all the markers statistically correlated with DD severity. The present study confirmed the presence of a main oxidative imbalance in DD and provides evidence of platelet activation driven by LPS translocation. The use of circulating biomarkers could represent a new clinical tool for monitoring disease progression and validate therapeutic strategies never tested in DD as antioxidant supplementation.
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Affiliation(s)
- Lucia Pallotta
- Department of Translational and Precision Medicine, Sapienza University of Rome, Viale del Policlinico, 155, 00161 Rome, Italy; (A.G.); (M.S.); (D.C.); (M.C.); (C.S.)
| | - Vittoria Cammisotto
- Department of Clinical, Internal Medicine, Anaesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico, 155, 00161 Rome, Italy; (V.C.); (S.B.); (C.N.); (F.V.); (P.P.)
| | - Valentina Castellani
- Department of General Surgery and Surgical Specialty, Sapienza University of Rome, Viale del Policlinico, 00161 Rome, Italy;
| | - Alessia Gioia
- Department of Translational and Precision Medicine, Sapienza University of Rome, Viale del Policlinico, 155, 00161 Rome, Italy; (A.G.); (M.S.); (D.C.); (M.C.); (C.S.)
| | - Margherita Spigaroli
- Department of Translational and Precision Medicine, Sapienza University of Rome, Viale del Policlinico, 155, 00161 Rome, Italy; (A.G.); (M.S.); (D.C.); (M.C.); (C.S.)
| | - Dominga Carlomagno
- Department of Translational and Precision Medicine, Sapienza University of Rome, Viale del Policlinico, 155, 00161 Rome, Italy; (A.G.); (M.S.); (D.C.); (M.C.); (C.S.)
| | - Simona Bartimoccia
- Department of Clinical, Internal Medicine, Anaesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico, 155, 00161 Rome, Italy; (V.C.); (S.B.); (C.N.); (F.V.); (P.P.)
| | - Cristina Nocella
- Department of Clinical, Internal Medicine, Anaesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico, 155, 00161 Rome, Italy; (V.C.); (S.B.); (C.N.); (F.V.); (P.P.)
| | - Martina Cappelletti
- Department of Translational and Precision Medicine, Sapienza University of Rome, Viale del Policlinico, 155, 00161 Rome, Italy; (A.G.); (M.S.); (D.C.); (M.C.); (C.S.)
| | - Stefano Pontone
- Department of Surgery, Sapienza University of Rome, Viale del Policlinico, 155, 00161 Rome, Italy;
| | - Roberto Carnevale
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Corso della Repubblica, 04100 Latina, Italy;
- IRCCS Neuromed, Località Camerelle, 86077 Pozzilli, Italy
| | - Francesco Violi
- Department of Clinical, Internal Medicine, Anaesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico, 155, 00161 Rome, Italy; (V.C.); (S.B.); (C.N.); (F.V.); (P.P.)
- Mediterranea Cardiocentro-Napoli, Via Orazio, 80122 Naples, Italy
| | - Rosa Vona
- Center for Gender-Specific Medicine, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy;
| | - Carla Giordano
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Viale del Policlinico, 155, 00161 Rome, Italy;
| | - Pasquale Pignatelli
- Department of Clinical, Internal Medicine, Anaesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico, 155, 00161 Rome, Italy; (V.C.); (S.B.); (C.N.); (F.V.); (P.P.)
- Mediterranea Cardiocentro-Napoli, Via Orazio, 80122 Naples, Italy
| | - Carola Severi
- Department of Translational and Precision Medicine, Sapienza University of Rome, Viale del Policlinico, 155, 00161 Rome, Italy; (A.G.); (M.S.); (D.C.); (M.C.); (C.S.)
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